This 27YO female presented with eye pain, 3 days following falling down the stairs and hitting her right eye. Prior CT imaging revealed an associated right nasal fracture.
Optos imaging shows a broad area of commotio retinae superiorly. The commotio completely resolved 1 week later.
Learning Points:
Commotio retinae is caused by direct, blunt eye trauma. The outer retinal whitening is due to shearing of the photoreceptor outer segments.
The term “Berlin’s edema” is a misnomer and should not be used, since the retina is not edematous.
The acute white retinal changes usually resolve within several weeks. With resolution, the fundus appearance can normalize.
With more severe injury, outer retinal loss can allow RPE cells to migrate into the retina, giving a pseudo-retinitis pigmentosa appearance. Patients can also develop retinal breaks and detachment.
